Uterine lining can grow in far-flung locations

Wednesday

Nov 26, 2008 at 12:01 AM

DEAR DR. DONOHUE: For almost all this past year, I have had off-and-on pain in my lower abdomen. My doctor put me through all sorts of tests, including scans, but nothing turned up. Now I'm seeing a gynecology doctor, who thinks I have endometriosis. I'm not at all familiar with this. What does it entail?

Paul G. Donohue M.D.

DEAR DR. DONOHUE: For almost all this past year, I have had off-and-on pain in my lower abdomen. My doctor put me through all sorts of tests, including scans, but nothing turned up. Now I'm seeing a gynecology doctor, who thinks I have endometriosis. I'm not at all familiar with this. What does it entail?

— G.D.

The endometrium is the lining of the uterus. Every month, in preparation for nurturing a fertilized egg, it grows. If no egg is fertilized, the lining is shed during the menstrual period.

Endometriosis is uterine-lining tissue in places outside the uterus. It can be in or on the bladder, the bowel, the rectum, the ovary or the dropcloth (the peritoneum) that covers many abdominal and pelvic organs. Just like the endometrium in the uterus, this displaced endometrium grows every month under the influence of monthly hormones. The growth causes pain. Most often, the pain is felt in regions below the bellybutton. As many as 5 percent of women between the ages of 15 and 45 have it.

The endometrial tissue reaches these distant sites by passing through the fallopian tubes, the tubes through which eggs reach the uterus.

A doctor with a laparoscope can see the displaced tissue. A laparoscope is a telescopelike device inserted into the pelvic cavity through a small skin incision.

If the amount of endometriosis isn't extensive and if the pain isn't disabling, birth-control pills, along with anti-inflammatory drugs like ibuprofen, often can end symptoms. For more widespread disease, medicines that stop the production of estrogen dry up the transplanted endometrium. Sometimes, surgical removal of the displaced endometrium is necessary. Often, that can be done with a laparoscope and a laser or surgical instruments passed into the pelvis through small incisions. The woman frequently returns home the same day.

DEAR DR. DONOHUE: This isn't an illness, but it is an embarrassment. Quite often during a meal, my nose drips and drips profusely. I can't sit with a handkerchief on my nose throughout the meal. It always happens when I am eating with others, and frequently happens at home. Is there any way to put a stop to this?

— N.O.

That condition has a name: gustatory rhinorrhea. It happens to more people than you would believe. It could be a reflex reaction to the temperature of food, both hot and cold temperatures. Or it might be that chewing and swallowing set the runny-nose reflex in motion.

Atrovent nasal spray before eating can stop the flow. So can antihistamines taken about an hour before the meal. Antihistamines have different effects on different people. Some cause drowsiness. You have to experiment to find one that best suits you.

Don't use the spray or antihistamine all the time. Save it for social occasions.

DEAR DR. DONOHUE: I have heard that hot baths are dangerous. Are they?

— M.L.

How hot do you mean?

For most people, they are not dangerous. If someone has high, uncontrolled blood pressure, a hot bath could be troublesome. In hot water, body temperature rises a bit, and the natural response is dilation of surface blood vessels to lower body heat. That could cause a drop in blood pressure. I don't believe this is a major threat.

If a hot bath relaxes you, enjoy it.

DEAR DR. DONOHUE: My wife and I have started drinking a glass of wine daily for its heart benefits. Should it be drunk only at mealtime?

— D.P.

You can drink it anytime you want.

Those who don't drink alcohol shouldn't feel they are missing out on a great opportunity to prevent heart attacks. You can protect your heart in many other ways — a low-fat, low-cholesterol diet, an exercise program, weight reduction and maintaining normal blood pressure.

Readers may write to Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.